Chapter 12: Geriatric Pharmacology Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 12: Geriatric Pharmacology

Test Bank

MULTIPLE CHOICE

1. The nurse plans to closely monitor an older adult client who is receiving multiple drugs for evidence of adequate excretion of the medications. Which two major organs affecting drug clearance from the body should be monitored when an older adult client is receiving multiple drugs?

a.

Kidneys and lungs

b.

Kidneys and pancreas

c.

Liver and pancreas

d.

Liver and kidneys

ANS: D

The older adult client may experience a decrease in hepatic enzyme production, hepatic blood flow, and total liver function. These decreases cause a reduction in drug metabolism. A decrease in renal blood flow and decrease in glomerular filtration rate of 40% to 50% can also occur.

2. The nurse is aware that increased _____ may affect the absorption of medications.

a.

gastric motility

b.

alkaline gastric secretion

c.

intestinal emptying time

d.

peristalsis

ANS: B

An increase in alkaline gastric secretions may affect the absorption of medications, because gastric motility, gastric emptying time, and peristalsis are all decreased with increased alkaline gastric secretions.

3. The older adult client is prescribed a drug that is excreted through the urine. The nurse anticipates that which laboratory test will be prescribed to evaluate renal function before administration of the medication?

4. The nurse recognizes that polypharmacy is more likely to occur in an older adult client because the older client:

a.

has difficulty maintaining a list of current medications.

b.

experiences changes in visual capability.

c.

experiences alterations in mental capacity.

d.

may obtain prescribed drugs from various providers.

ANS: D

Polypharmacy is the prescription and administration of many drugs during the same period. This is more likely with the older client, who may see various healthcare providers to manage the health concerns that may accompany aging.

DIF: Cognitive Level: Application REF: pp. 187-188

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Health Promotion and Maintenance

5. The diuretic hydrochlorothiazide (HCTZ; HydroDIURIL) is usually prescribed for the older adult in a lower dose. The nurse recognizes that this is an attempt to prevent the older adult from experiencing a(n):

6. The nurse notes that Cimetidine has been prescribed for an older adult client. The nurses highest priority would be to call:

a.

the physician.

b.

the pharmacist.

c.

the nursing supervisor.

d.

Poison Control.

ANS: A

Cimetidine is not recommended for the older adult because of its side effects and multiple potential drug interactions. Famotidine, nizatidine, and ranitidine may be prescribed for the geriatric client instead of cimetidine.

12. A nurse is administering medication to an older adult client. The nurse is aware that the clients half-life is longer than that of middle-aged adults. What nursing intervention is indicated by this premise?

a.

Provide higher doses to achieve therapeutic effects.

b.

Assess the client for adverse reactions.

c.

Monitor the client for signs of accumulation.

d.

Provide education to the client on drug reactions.

ANS: C

Because older adults may have less efficient medication elimination, monitoring for accumulation is an important component of nursing care.

13. The nurse is caring for an older adult client who complains that she has to take multiple medications at various times throughout the day. What is the most appropriate nursing intervention for the nurse to implement with this client?

a.

Encourage family members or friends to monitor drug regimen.

b.

Explain the purpose, drug action, and importance of medication.

c.

Develop a chart indicating times to take drugs.

d.

Provide time for questions; reinforce with written information.

ANS: C

The nurse should help the client develop a chart indicating times to take drugs. Space should be provided to mark each drug taken. An organizer or calendar can be used to mark days and weeks.

14. The physician is recommending a benzodiazepine medication for an older adult client who has previously been treated with Valium. The nurse recognizes that which medication would be most appropriate for this client?

a.

Librium

b.

Dalmane

c.

Ativan

d.

Equanil

ANS: C

A short-acting benzodiazepine, such as Ativan, would be preferable to any of the other drugs to avoid prolonged sedation and addiction.